Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case report

BMC Cardiovascular Disorders

Case Report

Teja Chakrala¹  Anshul Jain¹  Roshni O. Prakash¹  Mustafa M. Ahmed²  Sahil Prasada²  Mohammed Al-Ani²  R. Ashton Vautier² 

[1] Department of Medicine, University of Florida, 1600 SW Archer Road, 32610, Gainesville, FL, USA;Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA;

关键词: Sarcoidosis;    Heart failure;    Cardiogenic shock;    Cardiac arrest;    Case report;   

DOI  :  10.1186/s12872-023-03238-3

 received in 2022-09-05, accepted in 2023-04-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundCardiac sarcoidosis is found to occur in approximately 5% of patients with sarcoidosis. Its presentation can typically range from complete heart block to ventricular arrhythmias. This condition can rarely present with severe heart failure and cardiogenic shock requiring aggressive and timely management strategies. Advanced imaging techniques are usually required to assist with its diagnosis.Case presentationA 70-year-old woman with a history of pulmonary sarcoidosis presented with non-ST elevation myocardial infarction, congestive hepatopathy, and acute renal failure. Left heart catheterization showed evidence of non-obstructive coronary artery disease, and right heart catheterization revealed severely elevated filling pressures and depressed cardiac index. She underwent aggressive diuresis and placement of an intra-aortic balloon pump in addition to initiation of inotropic and vasopressor support. While in the cardiac intensive care unit, she experienced frequent episodes of ventricular tachycardia and went into cardiac arrest requiring cardiopulmonary resuscitation. High clinical suspicion for cardiac sarcoidosis was confirmed by cardiac magnetic resonance imaging findings. After starting immunosuppressive therapy for cardiac sarcoidosis, she demonstrated clinical improvement.ConclusionPatients with cardiac sarcoidosis may remain asymptomatic or present with conduction abnormalities and arrhythmias. They rarely present with severe biventricular heart failure and cardiogenic shock, and in such cases, they require timely initiation of pharmacologic and device therapies, along with implementation of mechanical circulatory support.

【 授权许可】

CC BY   
© The Author(s) 2023

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